Thrombosis

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For some with sticky blood, treatment can be as simple as a daily aspirin. For those with antiphospholipid syndrome, drugs such as coumadin may be necessary.http://www.thrombosis.net/introduction/introcontent.htmThrombosis Thrombosis is

clearly the most common cause of death in the United States. About two million

individuals in the U.S.A. die each year from an arterial or venous thrombosis or the

consequences.

By comparison, about 540,000 individuals in the USA die each year from cancer.

About 80% to 90% of all causes of thrombosis can now be defined with respect to

cause. Of these, up to 90% of all patients harbor a congenital or acquired blood

coagulation protein or platelet defect which caused or contributed to the thrombotic

event.

It is obviously of major importance to define those individuals harboring such defects,

as this allows: appropriate antithrombotic therapy to decrease risks of recurrence, determination of the length of time the patient should remain on therapy for secondary

prevention, testing of family members in patients having a blood coagulation protein or platelet

defect which is hereditary (about 50% of all coagulation and platelet defects).

Some of the blood coagulation protein / platelet defects leading to arterial and venous

thrombosis (blood clots) are found at Blood Proteins.

Aside from mortality, significant additional morbidity (interference with quality of

life and creation of significant handicaps) occurs from both arterial or venous

thrombosis, including, but not limited to: Paralysis (non-fatal thrombotic stroke), Cardiac disability (repeated coronary events),Loss of vision (retinal vascular thrombosis) and recurrent miscarriage syndrome

(placental vascular thrombosis), Stasis ulcers and other manifestations of post-phlebitic syndrome (recurrent deep vein

thrombosis).

Almost all of these events are avoidable with appropriate diagnosis and specific

therapy defined for individual defects. Specific examples are as follows:

Recurrent Miscarriage

Deep Vein Thrombosis

TIA's and Stroke

Retinal Thrombosis

Coronary Thrombosis

Peripheral Thrombosis

SUMMARY AND ADDITIONAL INFORMATION:

The causes of hypercoagulability and overt thrombosis are becoming more clear and often

definitive with enhanced knowledge of hemostasis and the development and extended

utilization of testing systems useful for evaluating patients with thrombotic and

thromboembolic disorders. Using these test systems, in conjunction with careful

clinical assessment of patients, about 80% - 90% of patients with thrombosis will have a

defined etiology. Many of these will have an obvious clinical condition leading to

thrombosis and at least 50% - 80% will have an underlying hereditary or acquired blood

protein / platelet defect causing thrombosis.

It must be remembered that today a diagnosis of thrombosis is almost meaningless and

similar to and as general as a diagnosis of "anemia;" one must, in all

instances, as in anemia, ask next: WHAT IS THE SPECIFIC CAUSE OF THE

THROMBOSIS? Like anemia, appropriate therapy is highly dependent upon defining the

cause. Thrombosis, be it arterial or venous, can no longer be viewed as a general

diagnosis; approaching thrombosis in this manner probably accounts for not only many

treatment failures, but also for often confusing and conflicting results of clinical

trials.

Most Clinicians and most trialists approaching thrombosis as a generic diagnosis fail

to note that a very heterogeneous population is likely to be present and outcomes will

depend upon designing therapy specific for a given cause. As a simple example, it

would not make sense to treat a patient with thrombosis and harboring sticky platelet

syndrome with heparin or coumadin when they actually need aspirin; nor would it make sense

to treat a patient with antiphospholipid syndrome and thrombosis with aspirin (no

response) or warfarin (65% failure rate) when they respond most ideally to heparin.